Computer games may help older adults walk easier

NEW YORK (Reuters Health) - Older adults who tried special
brain training computer games had better gait and balance than
their peers afterward, in a new study.

Walking requires people pay attention and use other thinking
skills. In theory, slips and falls are more common for older
people not only due to physical frailty, but to mental aging as
well.

"Participants in this study were on average 83 years old,"
Renae L. Smith-Ray said. "Because we know that degradation
occurs with aging, in older participants we often consider
interventions successful when they prevent or slow future
decline."

Smith-Ray led the study at the Center for Research on Health
and Aging at the University of Illinois at Chicago. She found
the computer games did just that: they slowed the decline of
people's balance and walking speed.

The researchers randomly split 51 men and women age 70 and
older into two groups. People in one group used the
computer-based brain training program InSight for 10 weeks.
Those in the other group were monitored but didn't do anything
new.

Participants in the computer group played three games: "Road
Tour," "Jewel Diver" and "Sweep Seeker." The games were designed
to train visual and spatial memory and quick decision-making.

"Walking is a relatively automated task for younger adults
but becomes less automated for older adults," Smith-Ray told
Reuters Health.

"For instance, when walking down a busy street visuospatial
processing is required to identify cracks or tripping hazards in
the sidewalk, inhibition is required to tune out the distraction
of children running and throwing a ball down the block and
attention is required while watching traffic and responding to
signals."

The computer group met in a classroom three times a week for
one-hour sessions with the games.

At the end of ten weeks, participants who played the games
were able to get up from a seated position and begin walking a
couple of seconds faster than those in the comparison group, on
average. They had been in similar shape at the beginning of the
study.

But the computer game players didn't walk a 10-meter
(33-foot) course any faster than other participants, whether
they were distracted or not, at the end of the study.

The researchers also looked specifically at 30 of the
slowest walkers, who initially took nine seconds or longer to
walk 10 meters.

For slow walkers, walking speed and walking speed while
distracted were both better in the computer game group at the
end of the study, according to results published in The Journals
of Gerontology: Series B.

Still, the researchers can't yet say if this improvement
would be noticeable for most people in their daily lives or if
the games would actually help prevent falls.

They also didn't include people with dementia or known
learning problems in the study, so the results can't be widely
generalized, Dr. Alfonso Fasano said.

Fasano studies Parkinson's disease and age-related
conditions at the Neurology Institute of Università Cattolica
del Sacro Cuore in Rome. He was not involved in the new
research.

"Another important limitation of this study is that the
outcomes were assessed immediately post-training, but the major
obstacle to training in elderly is the decay of the improvement
over time," Fasano told Reuters Health.

"The authors should have seen the long-term outcome, also
assessing the number of falls and near-falls," he said.
The InSight program was developed by scientists for Posit
Science. The InSight program for two people can be purchased
commercially for $90.

"Executive functions are the cognitive processes that make
us uniquely human and control our ability to plan, set goals and
make good decisions," Smith-Ray said.

"The cognitive training program we used targets executive
functions, which is why participants who were randomized to the
intervention performed better on walking while distracted and
balance than participants randomized to the control group," she
said.

"Another important feature of any good cognitive training
program, including the Posit Science program, is that it adapts
to the users' performance: when the participant becomes better
at the task, the task becomes more difficult so that the
participant is constantly challenged."

But that's still only one part of the picture, Smith-Ray
said.

Physical changes in the brain influence mobility, and there
is also evidence for a "cognitive reserve," she said. That means
years of regular physical and social activity can help to slow
cognitive decline.

"The best way to enable healthy cognitive aging is by
regularly challenging your brain," she said.

SOURCE: http://bit.ly/1aJPBxm The Journals of Gerontology:
Series B, online November 5, 2013.

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